Registration
Back Handspring Clinic
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone:* Cell #: Work #:
Email: (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Who will be picking up your child? (ID required)*
Does your child have the skills required to take part in this event? (Must have a handstand, cartwheel, round off, and a bridge kick over to participate.)*
There will be no refunds for any reason. By enrolling in this Back Handspring Clinic, you are confirming that you have read and understand our no refunds policy.*
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*